Temporal Gut Microbial Changes Predict RecurrentClostridiodes DifficileInfection in Patients With and Without Ulcerative Colitis

Abstract

Background Ulcerative colitis (UC) carries an increased risk of primary and recurrent Clostridiodes difficile infection (rCDI), and CDI is associated with UC flares. We hypothesized that specific fecal microbial changes associate with UC flare and rCDI. Methods We conducted a prospective observational cohort study of 57 patients with UC and CDI, CDI only, and UC only. Stool samples were collected at baseline, at the end of antibiotic therapy, and after reconstitution for 16S rRNA sequencing. The primary outcomes were recurrent UC flare and rCDI. Logistic regression and Lasso models were constructed for analysis. Results There were 21 (45.7%) patients with rCDI, whereas 11 (34.4%) developed UC flare. Patients with rCDI demonstrated significant interindividual (P = 0.008) and intraindividual differences (P = 0.004) in community structure by Jensen-Shannon distance (JSD) compared with non-rCDI. Two cross-validated Lasso regression models predicted risk of rCDI: a baseline model with female gender, hospitalization for UC in the past year, increased Ruminococcaceae and Verrucomicrobia, and decreased Eubacteriaceae, Enterobacteriaceae, Lachnospiraceae, and Veillonellaceae (AuROC, 0.94); and a model 14 days after completion of antibiotics with female gender, increased Shannon diversity, Ruminococcaceae and Enterobacteriaceae, and decreased community richness and Faecalibacterium (AuROC, 0.9). Adding JSD between baseline and post-treatment samples to the latter model improved fit (AuROC, 0.94). A baseline model including UC hospitalization in the past year and increased Bacteroidetes was associated with increased risk for UC flare (AuROC, 0.88). Conclusion Fecal microbial features at baseline and after therapy predict rCDI risk in patients with and without UC. These results may help risk stratify patients to guide management.

Berberine ameliorates aGVHD by gut microbiota remodelling, TLR4 signalling suppression and colonic barrier repairment for NLRP3 inflammasome inhibition

“…BBR could renovate the abundances of genus Adlercreutzia, Dorea, Sutterella and Plesiomonas and increase the abundance of Lactobacillus in GVHD mice. The abundance of these 5 kinds of genus was reported to be decreased in IBD or GVHD patient except Plesiomonas and re-introduction of some of them could improve the disease in previous studies, [27][28][29][30][31] which were mostly in consistent with our result.…”

Development and Validation of a Novel Microbiome-Based Biomarker of Post-antibiotic Dysbiosis and Subsequent Restoration

“…These findings are consistent with ours and suggest MHI-A may have a role in predicting antibiotic response in CDI patients. A second study combined microbiome composition 14 days after CDI antibiotic treatment with patient clinical and demographic characteristics to predict CDI recurrence ( Lee et al, 2020 ). They found that increased Bacteroidetes, Lachnospiraceae , and Ruminococcaceae (Clostridia), and decreased Gammaproteobacteria correlated with reduced CDI recurrence, trends that are highly consistent with MHI-A.…”

Assessment of Causal Direction Between Gut Microbiota and Inflammatory Bowel Disease: A Mendelian Randomization Analysis

“…The Dorea identified in this study belongs to the Lachnospiraceae family, which mainly exists in the gut microbiota of mammals and humans. One previous study has established a link between Lachnospiraceae and IBD ( Lee et al, 2020 ). Another recent studies has also confirmed that the level of Lachnospiraceae and butyric acid gets decreased in IBD patients ( Sasaki et al, 2019 ).…”